Case-Based Discussion: A Case of Misdiagnosis of Primary Lung Malignancy
August 2019
in “
Thorax
”
TLDR A 69-year-old smoker was wrongly diagnosed with lung cancer but actually had a rare lymphatic system disorder.
A 69-year-old male smoker with a history of various health issues was misdiagnosed with primary lung malignancy. Initially referred for haematuria, a CT urogram revealed a 48 mm mass in the left adrenal gland, raising suspicion of malignancy. Further imaging showed a 6.5 cm mass in the right upper lobe of the lung, along with lymph nodes and multiple nodules in other lobes, and the large left adrenal mass was confirmed. Despite symptoms of breathlessness and weight loss, and a significant smoking history, the initial diagnosis of metastatic bronchogenic carcinoma with left adrenal metastasis was incorrect. Subsequent investigations, including a PET CT and histopathological examination, revealed the true diagnosis of lymphomatoid granulomatosis, a rare B-cell lymphoproliferative disorder.
